Resuscitator-aspirator-insufflator



Jan. 13, 1942. c. N. ERICKSON RESUSCITATOR-ASPIRATOR-INSUFFLATOR A v 1NVENTOR w 2 Sheets-Sheet 2 F z G.

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7i/Li. 35 s6 i2 s Patented -`lan. 13, 1942 Application November 21, 1939, Serial No. 305,468

16 Claims.

My invention relates to resuscitation equipment, particularly the pulmometric" type which automatically adjusts its displacement to the lung capacity.

One object of the invention is to provide simplied construction as compared with present resuscitators which embody a plurality of concentric cylinders and elongated conduits interconnecting the cylinders. Quick access for adjustment. inspection or repair and easy and accurate assembly in manufacture are among the objects of the invention. i

Another object ofy the invention isV the provision of a resuscitator embodying respectively an inspirating cylinder, an expirating cylinder and pistons or plungers therefor which are balanced and interconnected in a manner to insure proper alnement against seizing or jamming. Also the invention provides that the actuating cylinder which furnishes the power for both inspiration and expiration shall have the same area as the other cylinder to provide at low gas pressure, ample force to overcome friction and quicker response to the requirements of the patient.

Another object of the invention is to provide for practically instant conversion of a self-actuated pulmometric resuscitator into an insulator and to provide this feature initially at practically negligible added cost and with the simplified construction peculiar to this invention.

It will be understood that in the practice of mechanical resuscitation, as well as in many instances where the patient is anesthetized, occasion arises where an aspirator or fluid ejector is required for removal o f water, saliva, blood, and other fluids, and it is an object of this invention to provide a res'uscitator which may be instantly converted to serve as an aspirator and equally as quickly converted back to a resuscitator or insufllator as the case may require.` In fact the invention provides that practically without addition of parts, this new resuscitator, as well as other resuscitators, by an arrangement of conduits, ports and control valve peculiar to this invention, may be converted to an aspirator which. is driven by the same cylinder and piston which is ordinarily. used to drive the resuscitator.

Still another object of this invention is lto provide a resuscitator which is practically foolproof and 'can be used with any type of mask and which does not rely for its safety upon the safety valve usually provided in masks.

In the present resuscitator, as in well known types, there is provided a centrally located diaphragm-which controls inspiration and expiration valvular means and which requires elongated conduits or the like to be built into the device to convey gases to and from the respec-f tive cylinders and valves. It is another object of this invention to provide a housing construc- 'tion whereby the required passageways or con` duits may be simply incorporated in the walls of the housing.

Still other objects and advantages will appear son of appearing in connection with the ensuing description of the construction and operation of Figure 3 is a view taken on line 3-3 of Figure 1 showing parts hereinafter known as the diaphragm and toggle assembly.

Figure 4 is a full scale'fragmentary vertical section of the upper part of the device including a part known as the head; this section being taken mainly on a line 4 4 `of Figure 5.

Figure 5 is a full scale sectional view seen on a line 5-5 of Figure 1, showing the diaphragm and toggle assembly in plan. This view shows the control plug in resuscitator. position.

Figure 6 is a horizontal section of the control l plug and adjacent parts showing the plug in 35 aspirator position, the section being taken on a level slightly lower than that on which Figure 5 is taken and approximately on aline 6-6 of Figure 8. f

Figure 7 is a view similar to Figure 6 showing 40 the plug in insuillator position.

vFigure 8 is a vertical midsection seen on a line 8-8 of Figure 6 showing the plug in aspirator position.

In carrying out my invention I provide that which is in eiect a pressure cylinder and piston, actuated by gas under pressure under control of valves which will be hereinafterdescribed. This cylinder receives and expands gas on one stroke to develop power and then exhausts this expand- 0 ed gas on the other stroke. I further provide that which is in eect a single acting suction cylinder and piston which on one stroke draws air, gas or other uidsfrom aVv connected source and on the other stroke displaces such uid and 55 exhausts it to a point such as the atmosphere.

:hereinafter and will be better understood by rea- 'I'his suction pump is controlled by means of valves to be hereinafter described.

I provide a control plug for routing the gases vor fiuids to and from the respective cylinders.

In one position this control plug conveys gas at predetermined pressure to the pressure cylinder and conveys the then expanded gas at reduced pressure to a resuscitation mask or the like. While the pressure cylinder is undergoing a power stroke the control plug routes the suction effect from the patient and While the pressure cylinder is undergoing its exhaust stroke the plug routes this gas thru an inspiratory tube to the patient. The valves for the respective cylinders are actuated by pressure responsive means so that the stroke of each cylinder is varied according to lung capacity.

In a second position this plug while connecting the power cylinder with the source of gas pressure causes the exhaust gas from the power cylinder to be exhausted, the pressure cylinder in such case being merely an automatic expansion engine of the single-acting type. Meanwhile the pressure piston drives the suction piston while the control plug directs indraWn fluids from a catheter or the like thru a suitable liquid trap and the machine thus serves as an aspirator as for removing water,saliva or other liquids from mouth, throat, lungs or body cavities.

In a third position the cylinders are cut off while the control plug directs new gas under pressure to an insulator bag and connects the bag to deliver new gas to the patient while the expired gas is directed by the plug to the atmosphere,

The numeral Ill indicates a circular housing arranged with its axis horizontally disposed and provided with a fixed shaft I| on which is oscillatablymounted a hub l2. The shaft has at one end an integral annular enlargement |4 to act as one bearing for the hub and the hub fits closely between the front and rear walls Illa and |b respectively of the housing. This hub rotates in one direction by means explained hereinafter but is returned by means of a coil spring l5, said spring being fixed as at |5b at one end to the hub and at the other end as at |5a to the shaft. The circumferential wall of the housing is fully machined internally around its true center and is then fitted with a pair of diametrically opposedl vanes respectively provide a double cylinder unit in which each cylinder is single acting and changes its volume co-ordinately and simultaneously with respect to the other. The suction cylinder is provided with a non-return exhaust valve 29 arranged to exhaust direct to the atmosphere. Its suction port 30 is in the extreme lower end and the housing is provided with a cored or machined suction passage 3| which leads to the top of the housing. This suction passage and port 30 are controlled by a downwardly seating pneumatically actuated suction valve 33 seating on a suction-valve port or seat 34 provided at the top of the housing. An inverted cup-shaped head 35 is fitted over the top of the housing and provides a lung-pressure chamber 36 in which the suction valve 33 is disposed and into which the suction-valve seat 34 opens. The head 35 includes a control plug of the usual tapered type indicated at 3`| and fitting in a corresponding plug cavity 38 provided by the head andI disposed above and slightly forward of the front wall of the housing. The head 35 is provided with a safety valve 40 to relieve excess pressure from the lung-pressure chamber 36 and this is set at the slight pressure to insure against dangerous pressure being built up accidentally; Also this valve serves other purposes as will appear and in fact practically all the major parts of this apparatus serve a dual or triple function.

The head and adjacent portions of housing lll provide a pair of suction passages 42 and 43 respectively and the plug when in the position shown in Fig. 5 provides a by-pass port 44 which interconnects these passages. One passage 42 leadsfrom the suction valve seat 34 to the plug port 44 while passage 43 leads from the plug port 44 to the aforesaid long suction passage 3|.

The housing at a point under the head provides a pressure valve cavity 45 and in this cavity is fitted a double seating pressure-valve disc 46. The cavity 45 provides an upper exhaust seat 4l i on which the disc 46 seats when it is raised, and a vented as at 22, 22, to the atmosphere and while these ports are shown as freely open they may be of a size calculated to retard the rate of reciprocation. The vanes are here shown as integrally joined by a yoke 23 which acts as a second bearing for the hub and rides on the shaft i The varies are further secured to the hub as at 24 but only after the hub has been accurately turned before assembly of the machine. Each vane on its uppermost side is provided with a correspondingly shapedexible-lipped composition cup-25 held down by a corresponding plate 26 secured as by screws 2l,

supply seat 48 on which the disc seats when it is lowered.

The head and adjacent parts of the body provide a high pressure gas supply passage 50 which begins at a fitting 5I. It will be understood that as in any resuscitator, insufilator, or the like, a supply of gas at suitably reduced although superatmosphericy is provided as from any oxygen bottle or the like (not shown) suitably attached to the fitting 5|. Also it is customary for these devices to include a pressure reducing valve which is well understood in the art and not shown.

Passage 50 as at 50a travels horizontally, is fitted with a small throttle 5| adjusted only initially, and leads to the supply port or seat 43 of the valvecavity 45. Also passage 50a continues to join a booster passage 52 which passes down thru the adjacent web to the perimeter of the hub. Here the hub is provided with a surface groove 53 which registers with the passage 52 at certain positions of the pressure piston Ato also admit gas to the pressure chamber or cylinder.

From the valve cavity 45 a plurality of small ports 54, which avoid passage 50a, lead down thru the housing into the pressure cylinder so that same is supplied with gas whenever the pressure valve disc 46 is unseated from supply seat 48. The housing and head jointly provide an exhaust passage 56 which leads from the exhaust port or seat 41 over to the plug valve, where with the plug in the position shown n'Figures 5, e and '1 respectively, it registers with e semicircumferential groove 51 formed in the plug.

Also the head provides a pressure-registration port 58 which leads from the plug cavity, and from groove 51 when in the positions shown in Figures and 6, respectively, into the lung-pressure chamber. Groove 51 of the plug has a vertical extenson 60 whereby when the plug is in the positions shown in Figures 5 and 7 respectively it serves to conduct gas under pressure to hereinafter described ports provided' at higher elevations in the head, although when the plug is in the position shown in Figure 6 extension '60 is closed oi and the groove 51 becomesmerely a by-pass to interconnect passage 56 and port 58 to exhaust gas'from the pressure change er petitioner the plug will cause the machine to function for -aspirating fluids as from body cavities. l

- The plug is provided at the lowerv endl-with an inwardly opening non-return or non-rebreathing valve 10. VThis leads into a vent 1| which rises thru` the center ofthe plug and terminates in a plugport 1Ia positioned to register with bore 62a when the plug is turned about 90 degrees clockwise from the position shown in Figure 5, or into the position in which the plug is shown in Figure 7. That portion of the head immediately surrounding the lower end of the plug is provided lwith an insuiliator gas supply port 12 which penetrates themargin of the plug cavity to register with the-lower portion `of plug valve cavity to the lung pressure chamber v36 when the pressure valve is raised and when the plug 31 is in the position shown in Figure 6.

Above the several ports justl described -the head provides a pressure connectionfZ and a suction connection 63. 'I'hese are well understood in the resuscitator art and are tted each with a corresponding hose connecting'with any suitable breathingm'ask or lother respiratory device. 'I'he hoses, mask and the like are well understood in the art and are therefore not shown,

particularly since with this device jany convene tional mask will serve the purpose, the head 35 providingA the safety valve which prevents at-v taining excessive mask` pressure as -will` appearv hereinafter. The pressure iitting 62 is prov vided with a bore 62a -by which gas.- is supplied to a` patient under slight and controlled pressure both in resuscitator and insuillator operations.'y The suction connection 63 is provided with a bore 63a thru which spent gas is drawn or respired from the lungs o f a patient both in resuscitation and insuiliator actions althlin the foi'- mer actionthe machine provides a controlled suction pressure and displacement respectively. Th head provides a continuation 63h' to. borev a altho a by-plass groove 64 is prvidedin the plug to establish inter-commnicationbetween bores f Gidfan'd'ab when theplug is in the position shown in Figure 5. ('Jontiniiaticn 631i, leads freelyY into the lung-pressurechaniber; The' plug pro-'l vides a second suction by-pass' groove 65 iivhicli,` f

when the plug is moved about 90 degrees clockwise from shown in Figure 7, alsov 4eetaleiishesv i'riterreinnmunication between-bore 63a and continuation 632),.this groove "however having' afvent`, port position shown 1n Figure 5 temsitienf 86 leading out thru thetop of the plug directly to the atmosphere and thru which gas' isflnally exhaled.iininhalatonoperations.A

The plug also provides an aspirator groove y' comprising a horizontal portion 61 and a vertical extension 61m This groove-is inoperative with the plugin the position, shown in Figures 5 and 7 respectively, but in the position shownr in Figures 6 and 8 serves to connect suction passage 43 with an aspirator bore 68a provided in a hose connection 68. Connection 68 is provided with an automatic suction non-return valve 69 (see Figure) whereby air may be induced thru connection 68 inwardly. It will be understood thatany well known combination of catheter and uid trap m-ay be coupled by a hose (not shown) to this connection in cases where an aspirator or suction pump is required; such hose. uid trap, catheter and the like being well known in the surgical art and not shown inthe drawings. This invention provides however, that during resuscitation or insuiilatcr conditions a slight which both the suction valve and the pressurel valve are connected lto be raised and lowered simultaneously therewith. This yoke is guidedby vertical pins 15 carried 'by the housing; The

housing, at a point under-andslightly eccentricV to the head, provides an` atmospheric lchamber 16 vented to the atmosphere as at 11. Over this chamber 16 is disposed a circular pressure res sponsive .diaphragm 18, the diaphragm being' thereby subject at its upper side to positive or negative pressure of vairor gas in the lung-pres'-` sure ,chamber`36, although this pressure can never' r safety valve.

This fjdiaphragmgvs normally actuated byv 'afi extremely simple` iDlvl/ed snap-actionftog'gle generally indicated by l,the A'11uniera1`8l)., Thema-,ff phragin ris provided with `a central reenforcing lplate Il. fromfwhich ,rise al Pair of spaced fingers sa', as eeen finally: extending nerizontg11y.1jrne theiothe'rjeni itl is connected v'tothe other arm by .means'lof an adjustment screw 86 adjustable to j vary'thetension on the spring, the 'adjustment screw being carried byjthis 'other arm and the 'Smink tendina'flat iall timesilzi draw-the renite ends of thearms closer together whilekthey pivot at .their open ends on thefiingers y83, 83. -The adjacent U-shape arm is extended `thru a slot 14a` forineddn yoke 14 to operatively engage same while the remote end of thev other U-shape arm is held withinl certain limits of movement by a vertical stud 81 carried by the housing and having anenlarged head 81a to constrain the corre-` sponding arm.` It will be apparent now that whenV the diaphragm is vdepressed as by superatmospheric pressure from above or in the lungi pressure chamber, the toggle acts te lift the yoke and to raise the valves,` while suction or negative pressure in lung-pressure chamber 36' 'causes the diaphragm and togg'e to act to lower the valves simultaneously. l

There are conditions .when the diaphragm is to be raised and the valves accordingly lowered so that the suction valve is seated, as when pressure rise above` that Ipredete'ermined by; the

diierentials do not exist. This is done by a push rod 89 which extends from within the chamber 2 I, up thru the housing and into the atmospheric diaphragm chamber 16 to abut the under side of the diaphragm. This push rod is raised by means of a bell-crank 9D which is pivoted on a fixed pivot 9i within chamber 2I and engages the push rod but has a lower end Sla so disposed as to be struck and raised by the suction piston as it nears completion of an upward or suction stroke. To the lower end of the push rod is connected a spring 92 having its other end connected to the suction piston so that the piston acts to retract the push rod downwardly as this piston nears the end of its discharge or downward stroke. However, retraction of the push rod will not depress the diaphragm unless there is a superatmospheric pressure above it as the toggle will act to keep it elevated.

For resuscitator action the control plug is in the position shown in Figure 5. New gas under reasonable pressure passes from fitting 5I into the valve chamber as explained, the diaphragm being depressed and the suction and pressure valves 33 and 46, respectively, being up as shown in Figure 4. This gas therefore flows down thru the several small ports 54 into the pressure cylinder I1 and forces the piston down on its power stroke, this stroke storing energy in the spring I5. Meanwhile the suction piston is being raised to increase the volume of the suction cylinder I8 and to draw from a mask or a patients lungs via connection 63 and its bore 63a, ports 34, 42, 43, 3| and 30, into the suction cylinder. However, this suction piston in pulling from lungs of given capacity will lower the pressure to that for which the diaphragm and its toggle are set to respond and the diaphragm will snap into upper position and seat the valves 33 and 46 downwardly. Thus the lung capacity is measured and the device is pulmometric in the same sense as the resuscitator set forth in the Patent No. 1,893,670 issued Jan. 10, 1933, to M. H. Goodner.

When the pressure valve 46 seats downwardly it unseats from exhaust seat 41 and gas which has been taken in and indirectly metered by the pressure cylinder is now free to escape and does escape via the small ports 54 and the exhaust valve seat 41 and the passage 56 to the groove 51 of the plug. The vertical extension 60 of this groove is now in registration with the bore 62a of the supply or pressure connection 62 so that this gas can flow to the patient. The coiled spring I5 returns the pressure piston toward the uppermost position and so continues to displace oxygen to the patient. It is to be noted that, via pressure-registration port 58, the diaphragm 18 is subject to the pressure of gas going to the patient and is always ready to respond accordingly. However the lung capacity has been meas-l ured by the previous stroke and excess pressure will not be apt to be reached unless some unforeseen condition arises such hose o! contra-breathing by the patient, in which case the diaphragm may act to reverse the machine. Normally however, -th'e pressure piston rises until groove 53 in hab I2 comes into registration with port 52 whereupon there will be an extra supply of gas boosted into the pressure cylinder and into the pressure registration port 58 and the predetermined lung-pressure chamber pressure will be reached and the diaphragm will be depressed to act thru the toggle to raise the pressure valve t1 to close the exhaust port tl.

as constricted supply.

Also the suction valve 33 is then unseated and the vanes begin another combined power and suction stroke to measure more new gas while drawing spent gas from the patient. Altho the mechanism by which this resuscitation action is accomplished is novel, the results are not unlike that of the resuscitator described in the aforesaid patent.

If however, the resuscitation is hindered -by water or mucus in the throat, mouth or like cavities or 1f for any other reason an aspirating deviceis instantly required or useful, the plug 31 by means of its handle H may be quickly turned about 45 degrees clockwise into the position in which it is shown in Figures 6 and 8 respectively.

In this position of the plug the pressure bore 62a of connection 62 is shut off entirely as there is to be no connection with a respiratory mask or other device and while proeve 51 does not then provide connection with bore 62a it still interconnects passage 56 and pressure registration port 58, and the latter port still opens to the lung-pressure chamber 36.

Beginning with the power stroke, gas will-enter the small ports 54 via the raised pressure valve 46 and will force the piston down on its power stroke. The suction port 43 (see Figure 6) is now connected only with groove 61 and its extension 51a. and thereby with the aspirator hose connection 58 (see Figure 8) and the suction cylinder I8 will draw only from the aspirator hose connection 68 and will not draw thru the suction valve as passage 42 is now closed off (see Figure 6). There will therefore be no reduction of pressure in lung-pressure chamber to raise the diaphragm and therefore the combined power and suction stroke of the connected pistons will continue until the suction piston strikes the bell crank at SIa and thereby raises the push rod 89 to raise the diaphragm to seat the pressure valve downwardly. This unseats the pressure valve from the exhaust seat 41 and shuts off supply of gas to the pressure cylinder I1. Now the spring I5 tends to reverse the pressure piston and drive it upwardly. Meanwhile the suction cylinder I8 is discharging as usual thru the non-return exhaust valve 29. As the pressure piston rises, the gas therefrom is exhausted into groove 51 of the plug as in resuscitator action, but since bore 62a of pressure tting 62 is now shut on by the plug 31, this exhaust must go via pressure registration port 58 into the lung-pressure chamber 36 to escape via the safety valve to the atmosphere. The pressure required to open the safety valve is not enough to depress the diaphragm against the friction of the bell crank and push rod 89 and therefore the diaphragm remains up and the pressure valve remains down and the exhaust port 41 remains open until the suction piston has descended far enough to act thru spring 92 to pull down the push rod 89. When it so does, the pressure of exhausting gas in lung-pressure chamber 36, as determined by safety valve is enough to depress the diaphragm and raise the pressure valve 46 against the exhaust seat 41 to open the supply port or seat 48 so that a new power stroke begins.

It will be seen now that in aspirator action the power cylinder operates very much as in resuscitator action except that it exhausts to the atmosphere instead of to a patients lungs, while the suction cylinder acts as before except that it is connected to draw at any possible suction pressure from an aspirator hose connection instead of from a patients lungs.

To convert the machine to an insuiiiator the plug is moved to the position in which it is shown in Fig. '7, which is 90 degrees clockwise advance from the position shown in Figure 5. This causes both the bore 63a of suction fitting 63 and its continuation 63o to be vented to the atmosphere by groove 65. Likewise th'e vent port Ha comes into registration with bore 62a of pressure hose tting 62 so that this pressure hose fitting is connected with the interior of the insufliator bag, via the non-rebreathing valve and the passage 1I. With the diaphragm uppermost and the pressure valve down away from exhaust seat 41, gas is free to flow from the supply tting 5| thru passages 50 and 50a down thru booster. port 52 via groove 53 into the pressure chamber I1. From the pressure chamber the gas flows via the small ports 54 and the ports 41 and 56 to groove 51 and extension 60 of the plug and thence into the port 12 and down into the bag 13. If however, the diaphragm is not uppermost and the pressure valve 46 is seated over the exhaust port when insuiilator action is desired, the incoming gas will depress the power piston until it shall have raised the suction piston to strike the bell crank 90 to act thru the push rod 89 to raise the diaphragm. When the diaphragm is thus raised the pressure valve is moved down into exhaust position and the pressure piston will be returned by spring I5 until it is in such position that the groove in hub 53 is in position to admit gas freely to the pressure cylinder from which it feed-s Ito the insuiilator bag as h'eretofore -described. Then the bag may force gas to a patient via valve 16, port Ila and bore 62a while, when the patient exhales, the exhaled gas will flow via bore 63a, groove 65 and vent 66 to the atmosphere and cannot re-enter bag 13 because of the non-rebreathing valve 10.

I claim:

1. In a device of the class described, a housing providingrespectively a suction cylinder or chamber, a pressure cylinder or chamber, a diaphragm chamber, and a pressure valve chamber; said pressure valve chamber in continuous communication with said pressure chamber, pistons, one for and reciprocable .in each cylinder and interconnected to respectively accomplish a power stroke for said pressure cylinder and "a suction stroke for said suction cylinder simultaneously and a discharge stroke for said suction cylinder and an exhaust stroke for said pressure cylinder simultaneously, a control valve, a port leading from said suction chamber to said control valve, a suction valve port leading from said control valve into said diaphragm chamber, a suction valve at saidl suction valve port, a suction hose connection or port leading to said control valve, an exhalation port leading from said diaphragm chamber to said control valve, gas supply means including a supply port leading into said valve chamber, an exhaust port leading from said valve chamber to said control valve, a pressure-indicating port leading from said control valve to said diaphragm-chamber, a pressure hose fitting having avport leading to said control valve, a pressure responsive diaphragm in said diaphragm chamber connected to move said suction valve to close said suction valve port and to simultaneously move said pressure valve to close said supply port and to open said exhaust port when a predetermined suction pressure is attained in said diaphragm chamber by said suction piston, said diaphragm further acting to move said suction I valve to open said suction port and to move said pressure valve to close said exhaust port and to open said supply port when a predetermined super-atmospheric pressure is attained in the diaphragm chamber, said control valve normally connecting said first named port with the second named port and the third named port with said fourth' named port, and further connecting said sixth named port with the seventh named and eighth named ports respectivelywhereby gas is first supplied to said pressure chamber to move said pistons to cause said suction piston to draw from said suction hose connection, and power storing means to said pistons operating to move said suction piston thru an exhaust stroke while moving said pressure piston associated with discharge gas Ito said pressure hose connection.

2. The device as in claim 1 and further including an aspirator hose connection, a non-return suction valve for same, a port leading from said connection to said control valve, said control valve movable to aspirator position to bring said rst named port and said ninth named port into intercommunication and to close said second named port, and further to close said fourth' named port and said eighth named port while maintaining communication between said sixth named port and said seventh named port whereby the pressure piston and cylinder respectively act as an expansion engine to drive saidsuction piston to draw air onlyvia said aspirator hose connection.

3. The device as in claim 1 and further including an insufilator bag, said control valve providing respectively a high pressurel gas supply port leading to the interior of the bag, a low pressure gas port leading from the interior of the bag and an atmospheric exhaust port; said control valve movable to insuiilator position to connect said sixth named port with' said tenth nam-ed port and to connect said eighth named port with said low pressure gas-port, and to connect said third named port with the last named atmosphericexhaust port.

4.. The device as in' daim 1 and in which said housing is circular, a central shaft to said housing, a hub mounted to oscillate on said shaft, a pair of diametrically opposed 'xed webs cooperating with said hub to divide the interior of the housing to form the aforesaid pressure chamber and suction chamber respectively, said pistons being diametrically opposed and forming a substantially integral part of said hub.

5. The deviceas in claim 1 and in which said housing is circular, a central shaft to said housing, a hub mounted to oscillate on said shaft, a pair of diametrically opposed fixed webs cooperating with said hub to divide the interior ofthe housing to form the aforesaid pressure chamber and suction chamber respectively, said pistons being diametrically opposed and forming a substantially integral part of said hub, one of said webs providing a booster port leading from said gas supply means to said hub, that portion of the hub within the pressurechamber being provided with a groove positioned to register with said booster port when the pressure piston is adjacent the beginning of its power stroke.

6. In a device of the class described, gas supply means, a chamber, adapted to normally receive gas under pressure and to exhaust same, a pressure hose connection connected to normally receive the gas exhausted from said chamber, a' suction creating means operated by gas from said chamber, a suction hose connection normally connected with said suction creating means, an aspirator hose connection, and control means selectively movable to control the outflow through said pressure hose connection and the operation of said suction creating means thru said suction hose connection and to cause said suction creating means to draw only from said aspirator hose connection.

7. In a device of the class described, a suction hose connection, a pressure hose connection, a gas-expanding means connected to normally exhaust to said pressure hose connection, a gas operated suction creating means connected to normally draw from said suction hose connection, an aspirator hose connection,. and selectively operable valve means movable to disconnect said suction creating means from said suction hose connection and to connect said suction creating means to draw from said aspirator connection.

8. In combination with a resuscitator embodying a gaseous uid responsive means for promoting inhalation, a gaseous fluid operated means for subsequently promoting exhalation, a gaseous fluid responsive means for promoting aspiration including an aspirator hose connection, a supply of gaseous uid under pressure common to the first, second, and third named means, and means operable to'control the flow of fluid from said supply so as to render said means inoperative for resuscitation 'purposes and operative for aspiration purposes and vice versa.

9. In a device of the class described, a circular housing, a hub mounted to oscillate at the axis of the housing, a pair of diametrically opposed xed webs cooperating with the hub to divide the interior of the housing into a pressure chamber and a suction chamber respectively, a pair of diametrically opposed radial vanes to said hub providing pistons, one for and reciprocable in each chamber, a pressure chamber inlet port connected to supply gas to said pressure chamber, a pressure chamber exhaust port connected to deliver gas from said pressure chamber, a pressure valve between said ports movable to seat on either port, gas supply means connected to supply gas under pressure to said supply port, means operating at the end of a power stroke of said pressure piston to seat said pressure valve on said inlet port and to unseat said valve from said exhaust port and operating at the end of the exhaust stroke of said pressure piston to unseat said valve from said inlet port and to seat said Valve on said exhaust port.

10. The combination as in claim 9 and further including a power storing spring connected at one end to said hub and at the other end to fixed part of said housing.

11. The combination as in claim 9 and in which said last named means is directly actuated by movement of said pressure piston as it nears the end of its power stroke and is pheumatically actuated as the power piston nears the end of its exhaust stroke by the exhaust pressure of gas being then expelled by said pressure piston.

12. The 'combination as in claim 9 and in which one of said webs provides a booster port leading directly from said gas supply means to the perimeter of said hub in said pressure chamber, said hub being provided with a groove disposed to register with the booster port as the pressure piston nears the end of its exhaust stroke.

13. 'I'he combination as in claim 9 and further including a pressure hose connection connected with said exhaust port and a suction hose fitting connected to be drawn from by said suction cham-A ber.

14. The combination as in claim 9 and further including a pressure hose connection connected with said exhaust port and a suction hose fitting connected to be drawn from by said suction chamber, an aspirator hose connection and means movable to connect the last named connection with said suction chamber while disconnecting the suction hose connection therefrom.

15. In a device of the class described, gas supply means, a chamber adapted to normally re ceive gas under pressure from said supply means and to exhaust the gas, a pressure hose con nection connected to normally receive the gas exhausted from said chamber, a suction creating means operated by gas from said chamber, a suction hose connection normally connected to said suction creating means, an aspirator hose connection, an insufflator bag, and a valve movable from either normal position or aspirator position to insulator position to connect said gas supply to said insuffiator bag and to connect said bag to said pressure hose connection, and to disconnect said suction hose connection from said suction creating means and from said aspirator hose connection, and to connect the suction hose connection in direct communication with the atmosphere for exhalation purposes.

16. In a unit for selectively effecting resuscitation, insuillation and aspiration, a supply of gas under pressure, means connected in the unit for operation responsive to gas from said supply for promoting resuscitation, including a pressure hose connection and a suction hose connection, means including said pressure hose connection for discharging gas from said supply for insulation purposes, means connected in said unit and responsive to gas from said supply for promoting aspiration including an aspirator hose connection, and control means for routing gas from said supply to selectively operate the means for promoting resuscitation, the insufllation means for discharging gas from said pressure hose connection, and the means for promoting aspiration.

CLARENCE N. ERICKSON. 

